本文選題：桂方傷痛膏 + 扶他林乳膠劑�。� 參考：《廣西中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:探討自擬中藥桂方傷痛膏結合手法治療急性踝關節(jié)扭傷的臨床療效,探求其中臨床療效的差異,并對其中治療原理進行初步分析,以求總結出一種簡便效廉的治療方案。方法:研究中共收錄60例急性踝關節(jié)內翻扭傷的患者,隨機分為桂方傷痛膏結合手法治療的觀察組及扶他林乳膠劑結合手法治療的對照組。其中男性37例,女性23例,年齡在15~60歲之間。以《中醫(yī)病證診斷療效標準》(1994年)中關于踝關節(jié)扭傷部分作為診斷標準及治療后療效判定指標,并根據(jù)治療前后x線正位片踝穴寬度、患踝腫脹程度、關節(jié)活動度、VAS疼痛評分的變化情況進行對比,來觀察兩種治療方案的治療效果,以及桂方傷痛膏與扶他林乳膠劑對比的療效特點。將研究所得數(shù)據(jù)通過統(tǒng)計學分析整理,對兩種療法得出科學性、系統(tǒng)性的評價。結果:1.兩組患者治療前在性別、年齡、病程、踝穴寬度、患踝腫脹程度、關節(jié)活動度、VAS疼痛評分比較中差異均不具有統(tǒng)計學意義(P0.05),表明治療前組間基線一致,具有可比性。2.兩組患者治療前后踝穴寬度的組間對比差異并無統(tǒng)計學意義(P0.05),治療前后的組內對比差異均有統(tǒng)計學意義(P0.05),表明急性踝關節(jié)扭傷后發(fā)生踝穴形態(tài)改變,兩種治療方法均能恢復踝關節(jié)的解剖位置。3.兩組患者患踝腫脹程度的對比中,兩組治療前后的組內對比差異均具有統(tǒng)計學意義(P0.05),表明兩種療法均可改善患踝腫脹。而組間對比中,治療6天、9天后比較差異具有統(tǒng)計學意義(P0.05),桂方傷痛膏組的消腫效果更優(yōu)。4.兩組患者治療前后關節(jié)活動度的組間對比差異具有統(tǒng)計學意義(P0.05),桂方傷痛膏在改善急性踝關節(jié)扭傷后關節(jié)活動度方面更有優(yōu)勢。5.兩組治療前后VAS疼痛評分比較,組內對比差異具有統(tǒng)計學意義(P0.05),可看出兩種療法均起到了止痛效果。治療后兩組相比較,兩組間差異具有統(tǒng)計學意義(P0.05),扶他林乳膠劑組的止痛效果更強。治療結束1月后的組間對比,差異無統(tǒng)計學意義(P0.05),表明兩種治療都取得不錯的遠期效果。6.兩組療效比較,治療后總有效率均為100%,在總有效率上并無差異。但觀察組治愈數(shù)上占優(yōu),治愈率優(yōu)于對照組。結論:急性踝關節(jié)扭傷的治療中正骨復位可及時糾正踝關節(jié)的錯位,此方法迅速有效,而桂方傷痛膏在消腫、改善關節(jié)活動障礙中具有優(yōu)勢,扶他林乳膠劑作為經(jīng)典的非甾體抗炎藥,在緩解軟組織損傷后的疼痛中得到到廣泛認可。實際臨床急性踝關節(jié)扭傷的治療中,可考慮正骨復位后,桂方傷痛膏與扶他林乳膠劑聯(lián)合應用,以發(fā)揮各自優(yōu)勢。
[Abstract]:Objective: To explore the clinical effect of the combined manipulation of Gui Fang Shang Tong paste combined with manipulation in the treatment of acute ankle sprain, and to explore the difference in the clinical effect, and to make a preliminary analysis of the principle of treatment in order to sum up a simple and efficient treatment scheme. Methods: a total of 60 patients with acute ankle varus sprain were collected and randomly divided. The control group was treated with Guifang Yi Tong ointment combined with manipulative treatment and the combined manipulation of vitamin A in the control group, of which 37 men and 23 women were aged between 15~60 years. The diagnosis standard of ankle joint sprain in 1994 (1994) was used as the diagnostic criterion and the evaluation index of the curative effect after treatment, and according to the X before and after treatment. The width of the line position of the ankle, the degree of swelling of the ankle, the degree of joint activity, and the change of the VAS pain score were compared to observe the therapeutic effect of the two treatments, and the curative effect of the comparison between the ointment ointment and the cream of the cream of the cream. The data obtained by the study were statistically analyzed, and the two treatments were scientific and systematic. Results: 1. the differences in sex, age, course of disease, ankle width, ankle swelling, joint activity and VAS pain score were not statistically significant before treatment in two groups (P0.05), indicating that the baseline between groups before treatment was consistent, and there was no statistical difference between group.2. two groups before and after treatment. P0.05, the differences in the group before and after treatment were statistically significant (P0.05), indicating the morphological changes of the ankle points after the acute ankle sprain, and the two treatments could restore the anatomical position of the ankle joint in the comparison of the degree of ankle swelling in the two groups of.3. groups, and the difference in the comparison between the two groups before and after the treatment was statistically significant (P 0.05), indicating that the two treatments could improve the swelling of the ankle. In the group contrast, the treatment was 6 days and 9 days later, the difference was statistically significant (P0.05). The swelling effect of the group of Gui Fang Tong Tong ointment was better than that of the group of.4. two. The difference of the joint activity between the two groups before and after treatment was statistically significant (P0.05), and the Gui Fang Tong Tong ointment was improved in the acute ankle joint. The degree of joint activity after sprain was more advantageous than the VAS pain score of.5. two groups before and after treatment. The difference in the contrast between the groups was statistically significant (P0.05), and the two treatments all had the analgesic effect. The difference between the two groups after treatment was statistically significant (P0.05), and the analgesic effect of the cream group was stronger. The difference between the groups after January was not statistically significant (P0.05), indicating that the two treatments had good long-term effects in.6. two groups, the total effective rate was 100%, and there was no difference in the total effective rate. However, the cure rate of the observation group was superior and the cure rate was superior to that of the contrast group. Conclusion: the treatment of acute ankle sprain is the bone reduction in the treatment of acute ankle sprain. It is quick and effective to correct the dislocation of the ankle joint in time, and the Gui Fang Tong Tong ointment has advantages in reducing swelling and improving joint activity. As a classic nonsteroidal anti-inflammatory drug, the cream is widely recognized in alleviating the pain after soft tissue injury. In the treatment of actual acute ankle sprains, the bone can be considered as a bone. After the reduction, the Kui Fang pain paste and the combination of the cream of the agent are effective in giving full play to their advantages.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R274.3

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